B.C. oncologist changing the face of breast cancer treatment

A Kelowna oncologist is applying an innovative breast cancer treatment and the success rate is staggering.

Dr. Juanita Crook, radiation oncologist for BC Cancer and professor of radiation oncology at UBC Okanagan, has used brachytherapy to treat breast cancer in about 75 B.C. women. These 75 women are now cancer free.

“The results are great, 100 per cent cancer free,” said Crook. “In the period of time I have been doing this nobody has had a recurrence of the tumour in the tumour site where it was treated.”

Treatments have been so successful that now each and everyone of her surgeries are teaching moments for doctors who fly in from all over North America to learn the treatment technique and take it home to their regions.

Brachytherapy is beneficial over traditional radiation or chemotherapy as it delivers a smaller, more targeted, dose of radiation that produces fewer side effects.

“Instead of external radiation where the treatment is given from the outside and beamed in, brachytherapy is a form of internal radiation where we are applying the radiation sources directly into the tumour or the tumour bed to deliver treatment from the inside out,” explains Crook.

“It is more accurate, it can be given over a short period of time and you can be given a higher dose as you are not beaming through the rest of the body, you are putting it right where it needs to be.”

It is also a one-time in-hospital treatment that could save cancer patients around the province countless hours and dollars travelling to and from treatment centres that provide traditional chemotherapy or radiation.

“In Kelowna especially, we have women coming from six, seven or eight hours away and if they are having radiation to the breast they have to be away from home. It is too far to travel back and forth everyday, so they have to be away from home for a month to get the radiation,” said Crook.

“If they are a candidate for this type of treatment, they’re excited because it means just coming for half a day for a one-hour procedure and they can go home the same day. It makes quite a difference for them. The women are very pleased.”

Brachytherapy has been a cancer treatment method for decades and has been used widely in the treatment of prostate cancer, but Crook is the first doctor to treat breast cancer with it in B.C.

“The technique that were using here was first developed for prostate cancer 25 years ago,” says Crook.

“We use this all the time now and have treated thousands of men in British Columbia with this successfully, it is a curative treatment, but aiming and delivering this radiation to the prostate is different than to the breast so the treatment had to be adapted.

“This treatment was developed by a colleague in Toronto about 12-14 years ago, I worked with him and when I moved to B.C. I wanted to adopt the program here.”

It is a treatment that she estimates could be used on 20 per cent of breast cancer patients. With approximately 3,700 B.C. residents diagnosed each year, that’s 740 people that could benefit from this treatment option.

“Only some tumour sites and locations are appropriate for this but when it can be used it is quite a benefit for the patient,” she adds.

This treatment could also be the difference for whether a woman has to make the tough decision to have a mastectomy or not.

“Surgeons working in communities far from Kelowna often have to do a full removal of the breast, a mastectomy, because their patient cannot travel to Kelowna for radiation treatment,” says Crook.

“If they can offer to this patient to come to Kelowna for the procedure and be home the next day, they can make it happen and save their breast. That is important.”

Crook reiterates that this treatment is a form of partial-breast radiation that has less toxicity and is done quickly.

“I cannot imagine it would be easy for any woman to have a mastectomy. They live with it, and adjust to it, but it is a very difficult thing to go through,” adds Crook. “Given a choice, I’m sure the vast majority of women would prefer to keep their breast.”

Since 2012, the permanent radioactive seed implants for breast cancer have been offered in Kelowna for selected women following lumpectomy.

While Crook says most surgeons in B.C. are now aware of this option, she hopes breast cancer patients will talk to their surgeon to ensure this treatment option has been considered.

“Discuss it with your surgeon before surgery,” urges Crook. “Tell them you would like to have this treatment if it is possible. Many surgeons know about it now and many have phoned me and asked what they need to do differently in their surgery to ensure their patient is suitable for this.”

Crook has spent her career in cancer treatment, calling Kelowna home for the last nine years.